(MDHS), childhood mortality rates have declined since 1992. Infant mortality has decreased from 135 deaths per 1,000 live births in 1992 to 42 in 2015-2016. During the same period, under-5 mortality has markedly declined fourfold from 234 to 63 deaths per 1,000 live births. Graph 11: Child Mortality Rates: Source – Ministry of Health and Demographic Survey – 2015 - 2016 241 The under-5 mortality rate differs by residence, district, and household wealth for the tenyear period before the survey. Children in rural areas are more likely to die young (77 deaths per 1,000 live births) than children in urban areas (60 deaths per 1,000 live births). Under-5 mortality is higher among children in the poorest households (83 deaths per 1,000 live births) than among children in the wealthiest households (60 deaths per 1,000 live births). 242 The 2015-16 MDHS asked women about deaths of their sisters to determine maternal mortality—deaths associated with pregnancy and childbearing. The maternal mortality ratio (MMR) for Malawi is 439 deaths per 100,000 live births for the seven-year period before the survey. The confidence interval for the 2015-16 MMR ranges from 348 to 531 92